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Related Experiment Videos

Pertussis requiring intensive care.

Julia Surridge1, Elizabeth R Segedin, Cameron C Grant

  • 1Paediatric Intensive Care Unit, Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand.

Archives of Disease in Childhood
|July 6, 2007
PubMed
Summary
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Pertussis (whooping cough) in infants is severe, often requiring intensive care. Key symptoms like apnoea and paroxysmal cough indicate a higher risk of death or disability, especially with early discharge.

Area of Science:

  • Pediatric Infectious Diseases
  • Critical Care Medicine
  • Epidemiology

Background:

  • Pertussis (whooping cough) remains a significant cause of severe respiratory illness in infants.
  • Intensive care unit (PICU) admissions for pertussis highlight the severity of the disease in young children.
  • Understanding risk factors for poor outcomes is crucial for managing pediatric pertussis.

Purpose of the Study:

  • To characterize children admitted to the pediatric intensive care unit (PICU) for pertussis.
  • To identify clinical factors associated with increased risk of death or disability in these children.
  • To evaluate the impact of discharge timing on patient outcomes.

Main Methods:

  • Retrospective audit of pertussis admissions to the national PICU in Auckland, New Zealand.

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  • Data collected from 1991 to 2003, including patient demographics, clinical presentation, interventions, and outcomes.
  • Statistical analysis to identify risk factors for adverse outcomes, including death, disability, and readmission.

    • Main Results:

    • 72 infants (<12 months) admitted to PICU with pertussis; annual admissions increased over time.
    • Apnoea or paroxysmal cough (83%) and short cough duration (<8 days) were common presenting symptoms.
    • 49% required assisted ventilation; 4% died, and 19% were readmitted to PICU.
    • Risk factors for death/disability included co-morbidity, elevated lymphocytes, seizures/encephalopathy, shock, high PIM score, abnormal neurological signs, and PICU readmission.

    Conclusions:

    • Apnoea and paroxysmal cough are critical indicators in infants with short-duration pertussis cough.
    • Death or disability is frequent among infants requiring PICU admission for pertussis.
    • Clinical factors can identify high-risk children, and early PICU discharge is linked to increased readmission and adverse outcomes.